How much rates vary
Facilitymedian $78 · 10th to 90th $18 to $417Professionalmedian $39 · 10th to 90th $26 to $59
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $21.88 Median $37.15 Typical High $57.54 | Professional | None | $21.88 | $37.15 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $5.62 Typical High $8.71 | Professional | 55 · Aftercare only | $3.24 | $5.62 | $8.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $19.50 Median $91.20 Typical High $407.38 | Facility | None | $19.50 | $91.20 | $407.38 |
BCBS Idaho Setting Professional Modifier None Typical Low $28.18 Median $38.90 Typical High $60.26 | Professional | None | $28.18 | $38.90 | $60.26 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.39 Typical High $5.75 | Professional | 55 · Aftercare only | $2.82 | $3.39 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $17.78 Typical High $23.99 | Facility | None | $15.85 | $17.78 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $31.62 Typical High $44.67 | Professional | None | $25.70 | $31.62 | $44.67 |
Moda Health Setting Facility Modifier None Typical Low $21.88 Median $37.15 Typical High $57.54 | Facility | None | $21.88 | $37.15 | $57.54 |
Moda Health Setting Professional Modifier None Typical Low $25.12 Median $42.66 Typical High $66.07 | Professional | None | $25.12 | $42.66 | $66.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $5.62 Typical High $8.71 | Professional | 55 · Aftercare only | $3.31 | $5.62 | $8.71 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $54.95 | Facility | None | $30.90 | $30.90 | $54.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $30.90 Median $38.90 Typical High $69.18 | Professional | None | $30.90 | $38.90 | $69.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $275.42 Median $389.05 Typical High $512.86 | Facility | None | $275.42 | $389.05 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $67.61 | Professional | None | $33.88 | $42.66 | $67.61 |
Select Health Setting Facility Modifier None Typical Low $26.30 Median $26.92 Typical High $218.78 | Facility | None | $26.30 | $26.92 | $218.78 |
Select Health Setting Professional Modifier None Typical Low $16.22 Median $26.30 Typical High $36.31 | Professional | None | $16.22 | $26.30 | $36.31 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $19.95 Median $37.15 Typical High $58.88 | Professional | None | $19.95 | $37.15 | $58.88 |
15 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $18.62 Typical High $28.84 | Professional | 52 · Reduced service | $10.96 | $18.62 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $7.41 Typical High $11.48 | Professional | 53 · Discontinued | $4.37 | $7.41 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $3.72 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.19 | $3.72 | $5.75 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $29.51 Median $128.82 Typical High $616.60 | Facility | 50 · Both sides | $29.51 | $128.82 | $616.60 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $42.66 Median $58.88 Typical High $91.20 | Professional | 50 · Both sides | $42.66 | $58.88 | $91.20 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $30.20 Typical High $52.48 | Professional | 54 · Surgery only | $25.70 | $30.20 | $52.48 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $33.88 Median $39.81 Typical High $74.13 | Professional | 63 · Small infant | $33.88 | $39.81 | $74.13 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $19.95 Median $36.31 Typical High $43.65 | Professional | 78 · Unplanned return to OR | $19.95 | $36.31 | $43.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $18.62 Typical High $28.84 | Professional | 52 · Reduced service | $11.22 | $18.62 | $28.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $7.41 Typical High $11.48 | Professional | 53 · Discontinued | $4.47 | $7.41 | $11.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $3.72 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.24 | $3.72 | $5.75 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $58.88 Median $58.88 Typical High $93.33 | Professional | 50 · Both sides | $58.88 | $58.88 | $93.33 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $26.92 Typical High $43.65 | Professional | 54 · Surgery only | $26.92 | $26.92 | $43.65 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $6.31 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $6.31 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.84 Median $28.84 Typical High $46.77 | Professional | 78 · Unplanned return to OR | $28.84 | $28.84 | $46.77 |
Where Idaho sits
The same service costs 3.0 times more in Alaska than in Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 12th of 51
$38.90
AK $69.18VA $22.91
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.